Physical symptom complaints, cognitive emotion regulation strategies, self‐compassion and diabetes distress among adults with Type 2 diabetes

Aims Diabetes‐related distress is common among adults with Type 2 diabetes and is consistently associated with poorer self‐management and treatment outcomes. However, little is known about the psychological factors that may contribute to or protect against diabetes distress. This study examined illness burden, and positive and negative ways of thinking and relating to oneself in times of stress, as independent correlates of diabetes distress, cross sectionally and longitudinally. Method A total of 120 adults treated for Type 2 diabetes reported their physical symptom complaints, cognitive emotion regulation, self‐compassion and diabetes distress at baseline; 110 completed a 3‐month follow‐up assessment of diabetes distress. Pearson correlations and multivariable linear regression tested baseline and longitudinal relationships. Results Baseline diabetes distress was associated with greater use of negative cognitive emotion regulation strategies (r = 0.43, P < 0.01), greater tendency towards self‐criticism, self‐judgement and over‐identification (r = 0.37, P < 0.01), and greater physical symptom burden (r = 0.50, P < 0.01). Baseline physical symptoms and negative cognitive emotion regulation were independently associated with baseline diabetes distress. Baseline physical symptoms and negative aspects of self‐compassion significantly predicted diabetes distress over 3 months. Positive aspects of cognitive emotion regulation and self‐compassion were not independently associated with diabetes distress cross sectionally or longitudinally. Conclusion Greater symptom burden along with the use of negative cognitive emotion regulation and negative aspects of self‐compassion were independently associated with diabetes distress. If these relations are explained by causal influence, these modifiable factors could be fruitful targets for intervention research. What's new? Our study evaluated the independent roles of physical symptom complaints, and negative and positive cognitive emotion regulation strategies, in relation to the experience of diabetes distress over time in adults with Type 2 diabetes. We identified independent effects for physical symptom complaints and negative aspects of cognitive emotion regulation and self‐compassion in relation to diabetes distress. Previous studies have paid limited attention to individual‐level factors that may explain risk for diabetes distress, and our results suggest an independent role for physical symptom complaints and nega